Trends in the Aggressiveness of End-of-Life Cancer Care in the State of Qatar

Hassan, Azza; Mohsen, Hassan; Allam, Ayman; Haddad, Pascale

doi:10.1200/jgo.2015.000620

Cited by 6 publications

(17 citation statements)

References 24 publications

(35 reference statements)

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“…This observation may be due to more intensive care rendered at the end-of-life (EOL), prior to the patient passing on in the hospital. This finding has been reported in other studies [68, 69]. Supporting this observation, subgroup analyses showed that ICU and HD admissions were almost three times more common in visits which ended in death than in those which did not end in death, with the prevalence decreasing with age.…”

Section: Discussionsupporting

confidence: 88%

Drivers of hospital expenditure and length of stay in an academic medical centre: a retrospective cross-sectional study

Rahman

Ramachandran

et al. 2019

BMC Health Serv Res

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Background: As healthcare expenditure and utilization continue to rise, understanding key drivers of hospital expenditure and utilization is crucial in policy development and service planning. This study aims to investigate micro drivers of hospital expenditure and length of stay (LOS) in an Academic Medical Centre. Methods: Data corresponding to 285,767 patients and 207,426 inpatient visits was extracted from electronic medical records of the National University of Hospital in Singapore between 2005 to 2013. Generalized linear models and generalized estimating equations were employed to build patient and inpatient visit models respectively. The patient models provide insight on the factors affecting overall expenditure and LOS, whereas the inpatient visit models provide insight on how expenditure and LOS accumulate longitudinally. Results: Although adjusted expenditure and LOS per inpatient visit were largely similar across socioeconomic status (SES) groups, patients of lower SES groups accumulated greater expenditure and LOS over time due to more frequent visits. Admission to a ward class with greater government subsidies was associated with higher expenditure and LOS per inpatient visit. Inpatient death was also associated with higher expenditure per inpatient visit. Conditions that drove patient expenditure and LOS were largely similar, with mental illnesses affecting LOS to a larger extent. These observations on condition drivers largely held true at visit-level. Conclusions: The findings highlight the importance of distinguishing the drivers of patient expenditure and inpatient utilization at the patient-level from those at the visit-level. This allows better understanding of the drivers of healthcare utilization and how utilization accumulates longitudinally, important for health policy and service planning.

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Section: Discussionsupporting

confidence: 88%

Drivers of hospital expenditure and length of stay in an academic medical centre: a retrospective cross-sectional study

Rahman

Ramachandran

et al. 2019

BMC Health Serv Res

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“…Indicators for aggressiveness were based on dosage of chemotherapy received in the last 30 days before death, the number of hospital and ER and ICU admissions 30 days before death, and the number of deaths in acute care [17]. Data showed that aggressiveness did decrease within this time from 82% of patients getting treated in ICU's to 71%.…”

Section: Aggressiveness Of Treatmentmentioning

confidence: 99%

“…This emotional burden is relieved by the presence of a strong multidisciplinary team that involve social workers like religious chaplains in Qatar [17]. However, during instances when there is a discord between the family's insistence on aggressive treatment and the doctor's plea for the patient to die in peace, a meeting is held with doctors, nurses, social workers, and spiritual advisors to encourage the family to not withhold DNR.…”

Section: Evolution Of Dnar Policy In Qatarmentioning

confidence: 99%

“…Currently, special prescription forms are required to prescribe opioids to both cancer and non-cancer patients [17]. Gaining access to these forms is easier for non-cancer patients as family physicians and general practitioners are eligible [17]. However, for cancer patients in Qatar, only oncologists and surgeons can obtain a special authorization permit to prescribe opioids to cancer patients, while family physicians are strictly prohibited.…”

Section: Drug Availabilitymentioning

confidence: 99%

“…In general, patients in either the inpatient or outpatient setting could have access to opioids, but only with special authorization as deemed necessary [17]. Currently, special prescription forms are required to prescribe opioids to both cancer and non-cancer patients [17].…”

Section: Drug Availabilitymentioning

confidence: 99%

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Palliative Care in Qatar, 2008-2016

Bharani¹,

Y²,

Helmy³

et al. 2018

J Palliat Care Med

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With the increase of geriatric population, there is rise in demand for services aimed at improving end-of-life care. Palliative care, through its five-component approach, focuses on improving the quality of life and provide relief from complications of serious illnesses. Although a widely accepted concept in other parts of the world, palliative care is a relatively new concept in the Middle East, having been initiated in Qatar only in 2008. The paper discusses the development of palliative care program in Qatar from its initiation in 2008 to its development until 2016, and aims to delineate a stepwise approach for establishment of a successful palliative care program elsewhere, especially in the Middle East, through the model used in Qatar. Primary research data was obtained through analysis of patient demographics and interviews, and secondary data was attained through literature review using PubMed, CINAHL and Google Scholar respectively. Through its multi-faceted approach, aligning with the national health strategy, meeting the rising demands of Qatar's population, involving a multi-disciplinary team, focusing on education and research, palliative care in Qatar has established a successful model. It is the first one in the region to get Joint Commission International accreditation, thus aligning in par with the international standards and is striving to meet the emerging needs of Qatar's population and uphold its title as a successful model.

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Aggressiveness in systemic anticancer therapy at the end of life in an oncology center

Ferraz-Gonçalves,

Silva,

Redondo

et al. 2024

Porto Biomedical Journal

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Introduction: An increasing aggressiveness in cancer treatment at the end of life (EoL) has been reported in several, but not all, countries. This study aimed to see how aggressive cancer treatment is at the EoL in an oncology center. Methods: Retrospective study of patients 18 years or older with a solid cancer diagnosis who died in 2017. The focus was systemic anticancer therapy (SACT), excluding hormonotherapy. Results: In 2017, 2024 patients with solid tumors died. Of those patients, 1262 (62%) were male, and the median age was 69 (range 19–97) years. The most frequent primary cancer was lung cancer, followed by colorectal and stomach cancers, and 740 (37%) patients had metastatic disease. The median interval between SACT and death was 61 days. Of the patients undergoing SACT, 216 (27%) did it in the last month of life, 174 (22%) between 8 and 30 days from death, and 42 (5%) in the last week. On multivariable analysis, head and neck, colorectal, breast, and melanoma primaries; age group (older than 65 years); and metastatic disease had statistical significance associated with SACT. Of these variables, only metastatic disease is more likely to undergo SACT. Conclusion: This study confirms the relatively frequent aggressiveness in cancer treatment at the EoL. Taking into consideration previously published data, it can be tentatively concluded that the use of SACT increased in the last month and the last week of life.

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Trends in the Aggressiveness of End-of-Life Cancer Care in the State of Qatar

Cited by 6 publications

References 24 publications

Drivers of hospital expenditure and length of stay in an academic medical centre: a retrospective cross-sectional study

Drivers of hospital expenditure and length of stay in an academic medical centre: a retrospective cross-sectional study

Palliative Care in Qatar, 2008-2016

Aggressiveness in systemic anticancer therapy at the end of life in an oncology center

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